title: Human papillomavirus and cervical neoplasia among female sex workers in Madagascar.
abstract: Human papillomavirus (HPV) prevalence and type distribution were estimated among 90 female sex workers (FSWs) aged 18 to 58 years in Antananarivo, Madagascar.
  
  
  
  A total of 90 FSWs aged 18 to 58 years in Antananarivo, Madagascar, were included in this study. Information on sexual and behavioral characteristics was obtained via a questionnaire. Exfoliated cervical cell specimens were collected for conventional cytologic examination and HPV DNA testing by polymerase chain reaction. The prevalence rates of HPV DNA and their corresponding 95% confidence intervals were stratified into the following 3 age groups: younger than 25, 25 to 34, and 35 years or older. To assess the association between HPV DNA positivity and sociodemographic and sexual behavioral factors, age-adjusted odds ratios and 95% confidence intervals were calculated using unconditional logistic regression.
  
  
  
  The HPV prevalence in exfoliated cervical cell specimens was 36.7%. The most common HPV types found were HPV-52 (11.1%), HPV-31 and -39 (each at 5.6%), and HPV-16 and -83 (each at 3.3%). The prevalence of low-grade squamous intraepithelial lesions was 3.3%, and that of atypical squamous cells of undetermined significance was 18.9%. No high-grade lesion was found. Although associations were imprecise, the HPV prevalence was higher among women who reported younger age at the first intercourse, contraceptive use, a history of cervical lesions, and no history of condom use.
  
  
  
  The prevalence rates of HPV and cervical lesions among FSWs in Madagascar appear higher than among FSW populations from other African countries with a relatively higher population-based prevalence of human immunodeficiency virus infection.
authors.affiliation: Gillings School of Global Public Health, University of Carolina, Chapel Hill, NC, USA. jenniferS@unc.edu
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Smith
authors.forename: Kathleen
authors.initials: K
authors.lastname: Van Damme
authors.forename: Nantenaina
authors.initials: N
authors.lastname: Randrianjafisamindrakotroka
authors.forename: Jie
authors.initials: J
authors.lastname: Ting
authors.forename: Tiana
authors.initials: T
authors.lastname: Rabozakandraina
authors.forename: Bodo S
authors.initials: BS
authors.lastname: Randrianasolo
authors.forename: Mbolatiana
authors.initials: M
authors.lastname: Raharinivo
authors.forename: Sandrine
authors.initials: S
authors.lastname: Zanasaotra
authors.forename: Marcia
authors.initials: M
authors.lastname: Hobbs
authors.forename: Allen
authors.initials: A
authors.lastname: Rinas
authors.forename: Myron
authors.initials: M
authors.lastname: Cohen
authors.forename: Patti
authors.initials: P
authors.lastname: Gravitt
authors.forename: Frieda
authors.initials: F
authors.lastname: Behets
mesh_terms: D000293:Adolescent; D000328:Adult; D052685:Alphapapillomavirus / Q000302:isolation & purification*; D002584:Cervix Uteri / Q000821:virology; D005260:Female; D006801:Humans; D008270:Madagascar / Q000453:epidemiology; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D012737:Sex Factors; D011477:Sex Work / Q000706:statistics & numerical data; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000821:virology; D014930:Women; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000209:etiology / Q000821:virology